Fresh capital for healthcare software start-up Smart Reporting

Cologne The increasing number of corona infected is also a problem for radiologists. Because Covid-19 patients with severe breathing difficulties or even lung failure are viewed by doctors using computed tomography (CT). With this special x-ray, the doctors want to better assess the course of the respiratory disease. However, radiologists in particular, who have not yet come into contact with the virus, are often uncertain when assessing the largely unknown clinical picture.

Wieland Sommer knows the complexity of creating such findings from his own experience and has therefore developed a way to support doctors. The radiologist is the founder of the start-up Smart Reporting and offers software that, among other things, allows radiologists to document their CT findings. Part of the software is now a report template especially for Covid 19 patients, which Sommer is currently making available free of charge.

When radiologists evaluate the CT images, they can use the Smart Reporting report template on their own computer. They are guided step by step through the application and receive clinical background information, reference images, common classifications and current recommendations from the international radiology societies on Covid-19. In addition, radiologists no longer write the findings in free text, but can use pre-made text modules.

The template for Covid 19 patients is one of many templates that Sommer developed together with doctors and IT specialists from his company Smart Reporting. “I am convinced that the medicine of the future is also a data science,” says Sommer. According to the company, more than 10,000 radiologists from over 90 countries worldwide use the smart reporting templates.

And it shouldn’t stop there: Smart Reporting has now collected 15 million euros for the further growth plans. This emerges from a communication that is available to the Handelsblatt. The Munich venture capitalist Yabeo is the lead investor. In the past, Smart Reporting already secured growth capital of 6.5 million euros as part of a first round of financing.

Basis for algorithms

In addition to the technological approach, Yabeo investor Matthias Sohler also won over the sales concept of Smart Reporting. “The great thing about smart reporting – in addition to the technology platform and medical expertise – is the pronounced diversification of the sales channel: that large companies like Agfa, General Electric or Siemens takes a B2B2C approach. ”If a hospital purchases a new CT device from one of the medical technology manufacturers mentioned, the Smart Reporting template can be included in the delivery.

With the fresh capital, Smart Reporting now wants to grow quickly. An expansion to the US market is planned, and reports for oncologists and cardiologists will soon be available. “In 2025, we calculate sales of more than 100 million euros,” says Sohler. In addition to radiologists, the company already offers its services to pathologists.

Prior to founding his company, Sommer had acquired expertise abroad: studied medicine in Heidelberg, Madrid and Berlin; Assistant doctor positions in radiology in Lausanne and Munich; Master’s degree in public health from Harvard University. Shortly before he founded Smart Reporting as a spin-off from a research project in December 2014, he was appointed professor of radiology at the Ludwig Maximilians University in Munich.

Back then, he was surprised that “big data” was spoken of everywhere. The basis for this – standardized documentation – was not given at all. The 40-year-old has a bold goal: Findings should become the standard for all medical documentation. Not only do other doctors benefit from this because they can understand the entries made by colleagues directly.

Wieland summer

The radiologist is the founder of the start-up Smart Reporting.

(Photo: Smart Reporting GmbH / Oliver Bellen)

Standardized data is also machine-readable and can train artificial intelligence. “We work with a large university hospital to develop algorithms, but that is currently not our core business. We offer the infrastructure, others train the algorithms, ”says Sommer.

The business area is therefore also attractive for other companies, such as the Heidelberg company Mint Medical, a spin-off from the German Cancer Research Center (DKFZ), or the French company Keydiag, which was founded in 2018.

“With the increasingly complex radiological imaging and increasing number of examinations in the daily workflow, the structured diagnosis will become even more important,” says Jens Vogel-Claussen. He is a senior physician at the Institute of Radiology at the Hannover Medical School and has chaired the “Thorax Diagnostics” working group at the German X-ray Society.

Smart Reporting founder Sommer has some supporters in his vision: In addition to co-managing director Johannes Huber, there are around 30 investors, including Wolfgang Reitzle, chairman of the supervisory board the DaxCorporations Linde and Continental. Sommer’s father is also a partner in the company, and he is also a radiologist.

More: A spray against Corona – biotech companies form new alliances.


Artificial intelligence diagnoses COVID-19 using CT

Advanced COVID-19 diseases can be detected better on X-rays and computed tomography (CT) scans of the lungs than with the usual PCR tests of throat swabs. An artificial intelligence (AI) from the Vienna AI laboratory Deep Insights is now copying the radiologists. It achieves a sensitivity rate of more than 90 percent with COVID-19 CTs. That should also be above the value of PCR tests.

At the end of 2019, a new disease began to develop in China, the lung disease COVID-19 triggered by the novel coronavirus SARS-CoV-2. Quarantine measures to contain the virus lead to production downtimes and increasingly serious consequences for the economy and everyday life.

Of course, this only applies in cases where the coronavirus has already reached the lungs and affected them. In earlier stages, there is little or nothing to see on X-ray and CT images. CT scans are usually only from the more severe cases that end up in a hospital where a CT can be done.

In the AI from Deep Insights is a convolutional neuronal network that has been trained with thousands of anonymized images. It always gives one of three possible results: COVID-19, pathological findings (which include, for example, MERS and pneumonia) or normal findings. In principle, the KI recognizes COVID-19 even on simple X-ray images, which can be produced in significantly more clinics and at significantly less cost; however, the detection rate for simple X-rays is not yet so high.

Deep Insights collaborated with radiologist Dr. to develop the AI ​​that was designed to support COVID-19 diagnoses. Domagoj Javor developed by LifeTec in Vienna and published as open source. The license (GNU Affero General Public License v3.0) allows extensive modifications, retransmission and commercial use. The brothers Hamilton and Aaron Kaplan, who are behind Deep Insights, also expressly call for their AI to be tried and further improved. She would be particularly happy about further anonymized CT and X-ray images in order to be able to further develop the AI.

Aaron Kaplan, Deep Insights

(Image: Daniel AJ Sokolov)

At the same time, Kaplan points out that AI cannot replace a doctor: “Ultimately, people have to make the right diagnosis based on their wealth of experience. The AI ​​presented does not know, for example, whether the patient is coughing and has a high fever Solution just be another tool in the medical toolbox. “

A disadvantage of a CT is that it can only be created in appropriately equipped clinics – which one would rather not go to during a pandemic if it does not have to be. In contrast to a throat swab, a CT can be done painlessly and there is a result within minutes. The costs are comparable.



Coronavirus: what are the implications for cancer patients?

Grandstand. With the coronavirus, we are living much more than a health crisis. It is also a test of resistance for our health systems, even for the countries considered as “best ranked” by the various evaluation institutes or bodies. The indicators used, such as economic performance criteria, minimization of the cost of production, satisfaction of a standard of equity specific to each company, now appear to be poorly calibrated and insufficient in the face of such an epidemic crisis. As this pandemic progresses, we understand less the absence of indicators relating to the conditions of practice of those who provide care and to their dedication.

The fight against Covid-19 goes beyond a fight against the epidemic. It is also a struggle to maintain care for other chronic or acute pathologies that have not disappeared during this epidemic period. No one can also conceal the social and economic consequences, possible obstacles to access to care for all. An estimated 3.5 million French people are affected by cancer in France and 382,000 new annual cases in 2018, i.e. around 1,450 new cases diagnosed every day of the week. The Minister of Solidarity and Health regretted that cancer screenings were no longer carried out, “Calling the French” to return to their doctor for these diagnostic procedures. This announcement is important but may not be sufficient or essential to avoid the potential serious consequences of delayed or unannounced diagnoses, treatments degraded by necessity, renunciations of care or the interruption of inclusions in therapeutic trials.

A national strategy to be implemented

It would now be necessary to quickly implement a coordinated national strategy with a coherent territorial variation adapted to the local epidemiological and health situation, even when efforts are made to limit the spread of the virus by containment and barrier measures. The paradox of our society overdone with inflationary regulations and saturated with organizations of all kinds, but which ultimately finds it very difficult to organize or impose cooperation in this unprecedented context. Yet we have entered a period when things that once seemed impossible are inevitable.

Read also “My confinement started in January, when the pain put me in bed”

Since the epidemic crisis and the post-containment period are expected to last several months, the fear of the medical community with which I associate and of the nursing staff of my establishment specialized in the fight against cancer is that we are faced with a first “wave” of more serious cases than before linked to deferred care. After this period of crisis, the duration of which no one can seriously determine, health facilities that have been under tension for many years may find it difficult, especially if they have been considered as “Covid-19 hospitals”, to be absorbed into reasonable times the care of patients awaiting treatment as well as the flow of patients with newly diagnosed cancer reintegrating a course of care. It will most certainly take months to restore optimal organization. In addition, even if the epidemic crisis ends, the deterioration of the economy could accentuate inequalities with all its consequences on access to healthcare, particularly in the case of cancer.

Towards an increase in mortality?

For breast cancer, the most frequent cancer in women, whose annual number of new cases is estimated at 54,000 in France, the surgical management of patients with favorable prognostic criteria has been postponed, in accordance with the opinion of the High Council of Public Health available from mid-March and on the recommendations of learned societies. Even if these are remarkable recommendations which are unanimous during this period, it should not be forgotten that these are expert agreements for degraded care which should not last, at the risk a loss of luck for patients with even cancer said to have a good prognosis. Other examples could be taken, such as pancreatic cancer, the incidence of which has more than doubled over the past twenty years and whose unfavorable prognosis means that any delay in diagnosis by limiting access to radiology services, that any delay in surgical management due to the absence of an available operating theater or access to post-operative resuscitation could inevitably lead to an increase in mortality.

The Lombardy region of Italy, very affected as everyone knows by the pandemic, has managed to organize itself to maintain adequate care for cancer patients during this epidemic plague. Several platforms (HUB centers) have been set up, dedicated solely to the treatment of cancer patients (including the European Institute of Oncology and the National Cancer Institute in Milan). They receive newly diagnosed surgical candidates from area hospitals more dedicated to treating Covid-19 patients. These Covid-19-free cancer hospitals can continue to care for cancer patients even if they are small cancers with good prognosis.

This attention-grabbing pandemic should not make us lose our minds. After having wagered on economic performance for years, we suddenly moved on to the almost exclusive total fight against the Covid-19. It must be remembered that there is a middle way in everything that avoids extreme attitudes while preserving the future.

Emmanuel Barranger Surgeon oncologist, director general of the Center for the fight against cancer Antoine Lacassagne, Nice (Fédération Unicancer)